Inside your pregnant body: hormones and other stuff to be aware of when working out

You won’t believe what goes on inside your pregnant body without you even realising!

If you are still feeling sick hopefully it will start to get better over the next couple of weeks. Chances are you haven’t noticed any drastic changes to your waistline yet, but you may have a bit of a bump, everyone is different. If you are an experienced exerciser make the most of the next couple of weeks before you have to start adapting your routine. If you are not an experienced exerciser then try and make active daily choices and do your daily exercisers (pelvic floor, bum and ab squeezes, see 3-Plan) and think about starting more regular, appropriate exercise once you have had the OK from your 12 week scan.

Try to remember how remarkable your body is. The journey to motherhood is incredible if you look at how your body changes and adapts to make its environment just right for your growing baby. This week we are going to look at what hormones are released in pregnancy and how they impact on exercise and the other changes that are going on inside your body that you should be aware of and reassured about in relation to safe exercising in pregnancy.

 

Hormones

Let’s look at four of the big players: relaxin, oestrogen, progesterone and insulin.

1. Relaxin

The role of relaxin is to relax the ligaments of the pelvis to enable the joints to separate to accommodate your growing baby. Later, for your pelvis to open up and your baby to be born.

However clever relaxin may be, it is not able to target the relaxing effect on just the pelvic area. It can cause joint laxity on ligaments and fibrous tissue anywhere in the body, including your back, hip joints, knees and ankles, which all become slightly more prone to injury. Its relaxing effect can also mean there is significant movement between pelvic joints which can range from mildly uncomfortably to excruciatingly painful.

Pregnant women may find that they have greater range of movement during pregnancy due to relaxin. This means it is really important not to overstretch when moving or stretching and stay within a normal range of movement. The effects of relaxin are less noticeable in first time mums; more so in subsequent and multiple pregnancies. It can take six months to return to normal levels (a small amount is always present in the body) but longer if you are breastfeeding, so relaxin is also a factor to consider in postnatal exercise prescription.

2. Oestrogen

Oestrogen has many important functions in pregnancy, including promoting growth of various bits and bobs like your uterus, breasts and your left ventricle (how marvellous!) It also has roles in regulating progesterone, the development of your placenta and baby and colostrum production.

Oestrogen also contributes to the increase in your metabolic rate and oedema (fluid retention), which both have an impact on your exercise programme. Regular exercise can help reduce fluid retention. Be mindful of your increased metabolic rate; you’ll need to take on extra calories if you are exercising (200-300 a day from healthy foods) and also have a slightly higher core temperature, so take care when working out not to overheat.

3. Progesterone

The roles of progesterone, like oestrogen, are many and varied. Levels of both increase steadily as pregnancy progresses. A function which will have a significant impact on working out is the way progesterone makes smooth muscle relax. This includes your oesophagus, blood vessels and digestive system (the reason for some of the delightful pregnancy ailments such as heartburn, varicose veins and piles).

Also impacting your exercise programme is the fact that progesterone helps to stabilise your blood pressure by relaxing your blood vessels and reducing venous return, meaning you may feel dizzy or light headed due to lower blood pressure.

It also increases your sensitivity to CO2, increasing oxygen levels when you breathe through an elevated breathing rate. This means you shouldn’t try and continue at pre-pregnancy exercise levels as you may be panting before you start!

Finally progesterone has the essential role of stopping important things happening before they should, including lactation and contractions.

4. Insulin

Insulin resistance increases in all women during pregnancy making their pattern of energy usage similar to that of a mild diabetic. This is actually your body’s way of making sure that blood glucose circulates for longer so that it can be properly absorbed by the placenta and the baby, so is not a bad thing! However, around 2-4% of women will develop gestational diabetes (which only lasts for the duration of the pregnancy) which may cause some birth defects and result in babies having to be delivered early by caesarean.

Gestational diabetes is usually treated through diet and exercise; overweight women are more likely to develop it. If you do suffer your Midwife will advise on treatment, but it will likely include healthy eating and regular exercise; what we should all be doing anyway!

The main thing to be aware of with exercise and pregnancy insulin levels is that regular training encourages increased insulin sensitivity, which could result in a drop in glucose being available to the baby during exercise. Just remember if you are working out to eat regularly and have a healthy snack before and after exercising.

If you have existing diabetes make sure you discuss your management plan with your Midwife so they can give you appropriate advice and support.

 

Your changing body during pregnancy

As you can see from our quick run down on the hormones there are lots of changes going on in your body during pregnancy, but this doesn’t mean you can’t be active. However, there are a few things to bear in mind. Just to make sure you have all the key information:

Be reassured:

Cool as a cucumber During pregnancy your core temperature rises by approximately 0.6 degrees celsius. Your sweat point lowers, enabling you to dissipate heat from yourself and your baby. This, along with a slightly elevated breathing rate, means that you have a fab inbuilt cooling mechanism and overheating is unlikely.

Go with the flow Cardio exercise will not compromise blood flow to your baby. Provided you are working out at a sensible intensity and not for too long (i.e. over an hour and a half) your body will direct blood to your baby ahead of your working muscles. Stop if your muscles feel fatigued.

Added bonus You are still getting all the ‘normal’ benefits of exercise in addition to the ones related to pregnancy. You’ll be boosting your immune system, improving your cardiovascular and muscle fitness and endurance, releasing endorphins and, hopefully, improving your body image.

Put your hands up! Some people say that you shouldn’t raise your hands above shoulder height in later pregnancy, in case the umbilical cord gets wrapped around your baby’s neck. This is an old wives’ tale and you can ignore it. Carry on raising your hands as long as it feels comfortable. You only need to be cautious if you have issues with high blood pressure.

Don’t count on it An old school of thought used to say in pregnancy your heart rate during exercise should not go above 140 BPM. There’s no right or wrong and every woman is different. A bit of a sweat is OK, but try to keep your effort level moderate – at around 60–70 per cent of your maximum heart rate. Don’t measure your heart rate; go by how you feel and make sure you can still hold a conversation (see page xx)

Be aware

Back in action If you lie on your back (supine) when your bump is big it may put pressure on your vena cava and affect blood flow, making you feel light-headed. This is called ‘supine hypotensive syndrome’. Avoid lying on your back for any length of time and try side and seated positions instead.

Full of hot air During pregnancy your need for oxygen increases, meaning your breathing rate rises. Later in pregnancy it also becomes harder to take a big breath as your belly expands. Moderate your workout intensity so you can breathe comfortably.

Huff and puff Progesterone is a hormone that relaxes smooth muscle and makes you more sensitive to CO2. This may mean your breathing rate increases and you get puffed more quickly. If this happens moderate your intensity.

Working overtime Your resting heart rate (HR) and blood pumped per beat will increase. This means that you should moderate cardio activity as pregnancy progresses. Keep your heart rate up, but make sure you are working at a sensible intensity and not pushing yourself too hard. Also, warm up gradually and steadily decrease intensity at the end of your workout – to bring your heart and breathing rates down gently.

Vascular underfill When you are first pregnant your body becomes less able to quickly divert your blood to where it is needed. This can make you feel dizzy and faint. If you do, adapt your exercise and avoid quick and frequent transitions (floor to standing etc) and being still for long periods.

How to sleep better during pregnancy, guest blog from Rennie Downes


leachco snoogle body pregnancy pillow

guest blog from Rennie Downes www.pregnancypillows.org

Finding optimal quality rest is crucial during pregnancy, yet a 1998 poll by the National Sleep Foundation shows that 78% of women find it harder to sleep now than at any other time during their lives (even given the disturbed rest likely to follow in the near postpartum months). Why is this, and why is rest so important when we are expecting a baby? What can we do when poor sleep / sleeplessness strike?

Poor sleep during pregnancy

There are many factors that can contribute to inadequate quality or duration of sleep during pregnancy. Anxiety over the birth and our new role as mother – sometimes manifesting as 3am list-making! – can often become a factor in the development of insomnia. Difficulty getting comfortable thanks to changing curves and aching joints may also play a factor to disturbed rest, as can back pain – the latter affecting 50-80% of pregnant women (spine-health.com).

Many expectant mothers will experience vivid or disturbing dreams during their pregnancy, and some could be woken up by the movements of their unborn child. A tendency to feel “overheated” is common, and we are likely to require more frequent night-time bathroom trips as our trimesters progress. 30-50% of pregnant women will also experience heartburn and 26% will suffer from RLS (Restless Legs Syndrome), so it’s really not surprising when the quality of sleep plummets in pregnancy.

Risk of complications

Nevertheless, expectant mothers are “sleeping for two” and as such it is doubly important for the health of both mother and child that adequate rest is acquired. A study by the NSF found links between poor quality slumber and elevated blood pressure in pregnancy (as well as an increased risk of preeclampsia) while other studies show that women who sleep less than six hours per night are more likely to experience longer labors and give birth by Caesarean section.

Poor sleep, depression and a weakened immune system are all inexorably related (poor sleep causes depression and vice versa) and each increases the risk of pregnancy complications (Science Daily). Unfortunately sleep medication is usually not an option during pregnancy, but there are many methods you can use to try to improve the quality of your sleep.

Five ways to better sleep

1) Try not to worry

As hard as it may sound, lying in bed worrying about the fact that you cannot sleep is only going to make your problem spiral. If insomnia strikes, don’t wait it out in bed – you are actually more likely to get back to sleep sooner if you get up and move about, engaging in mild, relaxing activity until your head is ready to hit the pillow.

2) Know your enemy

Insomnia has multiple symptoms, the most commonly known being the classic issue of going to bed only to find sleep impossible. Waking up early, finding it difficult to wake in the morning or regularly waking during the night are all other signals of insomnia, but then again you may feel sleepy for entirely different reasons altogether.

Daytime drowsiness can just mean you need more sleep – but sometimes it indicates underlying medical conditions like anaemia or sleeping disorders such as sleep apnoea, so it is very important to get your fatigue checked out and diagnosed accordingly. Even if your doctor confirms that it is just another symptom of pregnancy, it’s worth being able to rule sleep apnoea etc out as these can have a detrimental effect on your pregnancy and birth.

3) Relax through exercise

Whether you’re new to exercise or already have a regime in place prior to getting pregnant, moderate activity can be helpful to you during pregnancy for several different reasons. If you suffer a bad back, exercising can help strengthen your core and ease discomfort while well-timed aerobic activity – not too close to bedtime – can be an excellent cure for insomnia.

If you struggle to sleep during pregnancy, why not consider using exercise as a form of relaxation? Classes in prenatal yoga and aquatic exercise are both very popular and widely available, but there are many other possibilities too.

In contrary to what you may have been told by your family and friends, pregnancy is not normally a reason to give up your daily dose of cardio. In fact, cardiovascular exercise can help your body to build a larger, more efficient placenta for your baby – and there are many other benefits too. You will need to take things carefully, though, and avoid certain activities like contact sports; if you are unsure which activities are classified as safe, consult your physician.

4) Sleep well-supported

As your trimesters progress you are likely to be spending more time in bed sleeping (or at least resting) every week, so it’s really important that you find a way to get comfortable when doing so. Being able to achieve an optimal sleeping position in which your bump, back and legs can feel relaxed but well-supported goes further than just attaining a good night’s rest – it may also affect your level of discomfort throughout the day, particularly in the case of RLS, back pain or PGP (Pelvic Girdle Pain). If your hips are aligned into a neutral position it could even help baby get into position ready for the birth.

As your uterus expands it will become more and more impossible to lie comfortably or safely on your back, so doctors tend to recommend that you sleep on your left side – yet even this can put a lot of strain on your spine if unsupported. It is therefore recommended that you purchase a suitable maternity pillow to ease the increased weight and strain being placed upon your joints; such pillows are extremely versatile and can help you achieve the best sleeping position during pregnancy. What’s more, with such a huge amount of choices available on the market, you are sure to find the right size, shape and price for you.

5) Speak to your doctor

If all else fails, you are feeling very anxious or just cannot seem to get any sleep, don’t suffer in silence while everyone else dreams! Consult your physician about the possibilities that are open to you during pregnancy – he or she may be able to suggest a suitable medication or other avenues that you’ve not yet explored. Remember that however tired you may be feeling now, it is only temporary and soon everything will change again. Try not to despair, but don’t be afraid to ask for help!

Pelvic floor exercises to stop you wetting yourself!

Pelvic floor exercisers don’t have to be boring and they will stop you weeing yourself!

The pelvic floor (PF) muscles are located between your legs and run from your pubic bone at the front to the base of your spine at the back. You can think of them as a shopping bag or hammock which supports all of your internal organs – an important job. To stick with this analogy, if you imagine you keep loading up your shopping bag its base will come under more and more strain. In the same way, the weight of your growing baby will put increased pressure on these muscles. They can also be weakened and experience some trauma through childbirth.

Read more about the function of your pelvic floor and get tons of exercises on my latest page.

What cardiovascular (CV) exercise is best and safest during pregnancy and why should I bother?!

You may well be feeling a bit pukey and/or constipated (the delights of pregnancy) if you are still in trimester 1, but hopefully that will start to getting better over the next couple of weeks. This feature is all about cardiovascular exercise. If you can face some it may well help ease those pesky pregnancy symptoms.

Cardio exercise is important for keeping your heart and lungs fit and healthy. You’ll need a good level of fitness and endurance for labour (one of the most demanding things your body will ever go through!) and looking after a new baby and the rest of the family (and yourself of course!) Why would you NOT want to improve your cardio fitness?

Read more…..

Can I carry on running throughout my pregnancy?


Lucie half marathon

Why should I carry on running in pregnancy?

 Running is fantastic cardiovascular exercise and will help keep your heart and lungs fit and strong. In addition to all the usual benefits from exercising during pregnancy:

  • A shorter labour, with less likelihood of complications – I had quite enjoyable pregnancies with no sick days from work, straightforward and short labours (both under 5 hours) vaginal deliveries and a very quick recovery, was active within a couple of days!
  • Less likely to suffer from nausea and morning sickness
  •  Improved core strength and stability
  • A stronger back and reduction in back pain
  • Better posture
  •  Stronger pelvic floors
  • Better circulation, less likely to suffer from varicose veins, swelling and high blood pressure
  • Stronger bones
  • Avoid excessive weight gain and easier to get back into shape after the birth
  • More energy and self-confidence – lift your mood and feel great!
  • Strengthen the muscles used in childbirth
  •  It will help you sleep
  • Improved cardio-vascular fitness and muscle tone
  • Lessen the likelihood of developing gestational diabetes

With all of those benefits, why would you not exercise?! After pregnancy you will retain a lot of these benefits, in addition to finding it easier to lose excess weight and tone up. With running having some time outdoors and time to yourself are also great feel-good benefits.

One of the most common things I hear is that it is not safe to run during pregnancy. There is no one-size-fits-all response to this. It largely depends on your pre-pregnancy fitness level and running experience. If you have never been a runner do not start during pregnancy. If you have done a little bit of running I would suggest keeping it at a moderate intensity (jogging rather than running) and no more than 30 minutes a couple of times a week. If you haven’t done any running for at least a couple of months then do something else. If it feels at all uncomfortable then do something else. If you are an experienced runner then there is no reason you cannot carry on running during your pregnancy.

I carried on running…but was always safe and sensible

 I love all kinds of exercise, especially aerobics and other fitness classes, but running really is my all time fave and I ran up to the end of the second trimester with both of my pregnancies. After that it began to feel a bit uncomfortable, but that’s just me. Every woman is different and should listen to their own body. Some women continue to run throughout their pregnancies right to the end and some just don’t feel right running from the outset. Do what feels right for you. I also did my first full marathon when my first baby was 8 months old!

 Here are some points about running safely and sensibly during pregnancy:

  •  Avoid overheating
  • Eat before and after exercise, (a snack, not a three course meal) around an hour either side should do it
  • Wear a good bra and trainers when you are working out
  • Be aware of running conditions – look after your personal safety, stick to well-lit areas and avoid rough or hilly terrain
  • Your pre-pregnancy exercise and fitness levels will determine what level you can exercise at
  • Remember your pelvic floor exercises (even if you are having a c-section) as running does put extra pressure on these muscles
  • Adapt your running plan as your pregnancy progresses, see below
  • Warm up and cool down gradually
  • Stretch the muscles you used in your workout when you get home (all the big leg muscles)
  • Try to maintain a good posture (all the time!)
  • Stay well hydrated
  • Take care not to overstretch or push yourself too hard; the hormone relaxin makes your joints more prone to injury

Advice for running throughout your pregnancy: 

running in the first trimester

 During trimester one you can carry on as usual, as long as the intensity is not very high (i.e. intervals, sprinting), the duration isn’t too long (i.e. longer than 90 minutes) and you are not working harder than what you have been used to.

running in the second trimester

During trimester two you should start decreasing your intensity and duration once it starts to feel like it is becoming harder. Remember, you should be comfortably be able to maintain a conversation when you are working out. Your body is changing and although you can carry on running (although it should be ‘jogging’ – not too fast!) you should gradually start to adapt your workouts.

 running in the third trimester

During trimester three you may be able to carry on jogging if it still feels ok, but make sure you listen to your body and move on to a lower impact activity if it doesn’t feel right. Your bump may make you feel unbalanced or you may have some pelvic aches. Cross training, power walking, cycling and swimming are all great alternatives. If you do continue to jog then, once again, work at a comfortable intensity for a sensible duration and maybe build in some walk/jog sessions, alternating between each for five minutes at a time.

 Safety comes first:

In summary, if your pregnancy is low risk and you feel fine, don’t be frightened to continue something you enjoy, but remember running is high impact and you may feel more comfortable moving to gentler activities later on in your pregnancy with a view to taking up running again once you have had your baby. It’s up to you – every woman is different. Definitely ignore anyone that tries to criticise you jogging with a bump; we need to change the way people perceive pregnant women – start the revolution!

More about running in pregnancy here